crossing96/oncoscreening huggingface dataset:
Anterior fascial fixation does not reduce the parastomal hernia rate after radical cystectomy and ileal conduit.	OBJECTIVE: To compare the rate of parastomal hernia in patients undergoing anterior fascial fixation of the ileal conduit with that in patients without fascial fixation. Limited data exist on whether anterior fascial fixation of the ileal conduit impacts the rate of parastomal hernia. METHODS: A total of 496 consecutive patients undergoing radical cystectomy and ileal conduit reconstruction from 1995 to 2012 were retrospectively evaluated for parastomal hernia. All patients had a 2-fingerbreadth aperture and the ileal conduit brought through the rectus muscle and sheath. Patients were divided into 1 of 3 groups based on stoma fixation and/or reinforcement: anterior fascial fixation, posterior reinforcement, or no fascial fixation. A parastomal hernia was defined as a palpable bulge at the stoma site. Multivariate logistic regression was conducted for the primary end point of parastomal hernia, controlling for other patient- and treatment-related factors that might affect the rate of parastomal hernia. RESULTS: Median follow-up was 16 months (range, 1-189 months). The parastomal hernia rate was significantly greater in the anterior fascial suture group (43 of 281; 15.3%) than the no fascial suture group (12 of 164; 7.3%; P=.02). Multivariate logistic regression analysis modeled for the occurrence of a parastomal hernia demonstrated that anterior fascial fixation was an independent predictor of the development of parastomal hernia (odds ratio, 2.3; 95% confidence interval, 1.03-5.14; P=.04). CONCLUSION: Anterior fascial fixation of the ileal conduit does not reduce the risk of parastomal hernia formation compared with the patients treated without fascial fixation. Surgeons should consider avoiding anterior suture fixation during ileal conduit creation.	bladder
Bladder cancer biomarkers: review and update.	As the recurrence and mortality rates of bladder cancer are high, research is needed to find suitable biomarkers for early detection, evaluation of prognosis, and surveillance of drug responses. We performed a computerized search of the Medline/PubMed databases with the key words bladder cancer, biomarker, early detection, prognosis and drug response. Several markers were identified at DNA, RNA and protein levels with different sensitivities and specificities. Only a few of the potential bladder cancer biomarkers have been approved for clinical use. Efforts now should be concentrated on finding a panel of markers with acceptable sensitivity and specificity for early detection of bladder cancer.	bladder
[Small cell carcinoma in a vesical diverticulum: a case report].	We report a case of small cell carcinoma located within the vesical diverticulum. A 73-year-old woman referred to our hospital with a chief complaint of gross hematuria. Cystoscopy confirmed a non-papillary tumor within the vesical diverticulum. Histopathologic diagnosis with transurethral resection of the tumor (TURBT) specimen was small cell carcinoma. Later, tumor recurrence occurred within the same diverticulum. TURBT and biopsy of the vesical mucosa were performed. After confirming that no tumor was detected outside of the diverticulum, partial cystectomy was done including an adequate margin around the diverticulum in September, 2010. Since the histopathologic finding of the specimen revealed urothelial carcinoma (UC) this time and microinvasion and venous invasion were detected, we performed an adjuvant chemotherapy according to the protocol of gemcitabine and cisplatin therapy. To our knowledge, this is the 4th case report of small cell carcinoma located in a vesical diverticulum in Japan.	bladder
[A case report of metastatic renal cell carcinoma to the bladder].	70-year-old man was suffering from asymptomatic gross hematuria. Computed tomography demonstrated the mass in the right kidney, bladder, bone and lung. Cystoscopy revealed a solitary, nonpapillary lesion at the right side of the dome. At first, transuretheral resection of bladder tumor was performed. The pathological diagnosis was clear cell carcinoma of unknown origin. Sequentially, retroperitoneoscopic nephrectomy was performed. The pathological diagnosis of the right renal tumor was also clear cell carcinoma. The diagnosis was renal cell carcinoma metastasized to the bladder, bone and lung. To our knowledge, in Japan, this is the 45th case of metastasis to the bladder of renal cell carcinoma in the literature.	bladder
[SCF/c-Kit signaling promotes invasion of T24 cells via PI3K pathway].	OBJECTIVE: To explore the role of SCF/c-Kit signaling in the invasion of bladder cancer T24 cells. METHODS: Western blotting was used to detect the expression of c-Kit and PI3K pathway activation stimulated by stem cell factor (SCF) in T24 cells. The invasiveness of T24 cells before and after SCF stimulation and Wortmannin (aspecific PI3K inhibitor) treatment was evaluated using Transwell invasion assay (direct and indirect counting methods). RESULTS: T24 cells expressed c-Kit protein and showed obvious Akt phosphorylation after stimulation with SCF (1 ng/ml) for 24 h. Compared to the control group, SCF stimulation (1 ng/ml) caused a greater number of T24 cells to migrate through the polycarbonate film (P<0.01), and this effect was blocked by the application of Wortmannin before the stimulation. CONCLUSION: SCF/c-Kit signaling promotes the invasiveness of T24 cells, and this effect is mediated by the PI3K pathway.	bladder
[Value of dual-phase (18)F-FDG PET/CT in preoperative staging of bladder cancer].	OBJECTIVE: To investigate the clinical value of dual-phase (18)F-FDG PET/CT with oral diuretics in preoperative staging of bladder cancer. METHODS: The imaging data were analyzed of 73 patients with bladder cancer undergoing preoperative dual-phase (18)F-FDG PET/CT with oral diuretic between May, 2003 and May, 2012. All the patients underwent whole-body PET/CT scan 60 min after intravenous injection of 270-350 MBq of (18)F-FDG. Additional delayed pelvic PET/CT images were acquired after forced diuresis using oral furosemide (40 mg). All the patients underwent subsequent radical cystectomy, and (18)F-FDG PET/CT findings were compared with the histopathologic results to evaluate the value of dual-phase (18)F-FDG PET/CT in preoperative staging. RESULTS: The concordance rate of dual-phase FDG PET/CT-based bladder cancer staging with the histopathologic results was 63.0% in the 73 patients, and was 100% (7/7) for pT4 bladder cancers. With dual-phase FDG PET/CT, the detection rate was 75.0% (6/8) for lymph node metastases, 100% (4/4) for distant metastases, and 100% (4/4) for other concurrent primary malignancies. CONCLUSION: Though with limited accuracy in T-staging of pTa, pT1, pT2, and pT3 bladder cancer, dual-phase FDG PET/CT has important clinical value in staging of pT4 bladder cancer and in N-staging, M-staging and detection of other concurrent primary malignancies.	bladder
Bladder cancer: a portal into men's health.	Bladder cancer is the fourth most common cancer among men in the United States, with a 3-fold higher incidence than women. Globally, tobacco smoking remains significantly more common in men, contributing to half of all cases of bladder cancer. To prevent bladder cancer, urologists should promote smoking cessation to patients presenting at earlier ages with concerns such as sexual dysfunction, infertility, pelvic pain, or vasectomy. Bladder cancer also provides an entry point for men into the healthcare system, at which time, urologists can discuss and coordinate attention to other male health issues such as cardiovascular illness, depression, or addiction. By assuming the role of men's health physicians, urologists can have a significant benefit on men's urologic and overall health by targeting risk factors and behaviors.	bladder
Perioperative chemotherapy for muscle-invasive bladder cancer: A population-based outcomes study.	BACKGROUND: Practice guidelines recommend neoadjuvant chemotherapy (NACT) for bladder cancer. However, the evidence in support of adjuvant chemotherapy (ACT) is less robust. Here we describe whether the evidence of efficacy for NACT/ACT was sufficient to change clinical practice and whether the efficacy demonstrated in clinical trials was translated into effectiveness in the general population. METHODS: Electronic records of treatment were linked to the population-based Ontario Cancer Registry to identify all patients with bladder cancer treated with cystectomy in Ontario 1994-2008. Utilization of NACT/ACT was compared across 1994-1998, 1999-2003, and 2004-2008. Logistic regression was used to analyze factors associated with NACT/ACT. Cox model and propensity score analyses were used to explore the association between ACT and survival. RESULTS: Two thousand forty-four patients underwent cystectomy for muscle-invasive bladder cancer (MIBC). Use of NACT remained stable (mean, 4%), whereas utilization of ACT increased over time (16%, 18%, 22%; P = .001). Advanced stage (T3/T4; OR, 1.83; 95% CI, 1.38-2.46) and node-positive disease (OR, 8.10; 95% CI, 6.20-10.7) were associated with greater utilization of ACT. Five-year overall survival (OS) and cancer-specific survival (CSS) for all patients was 29% (95% CI, 28%-31%) and 33% (95% CI, 31%-35%), respectively. Utilization of ACT was associated with improved OS (HR, 0.71; 95% CI, 0.62-0.81) and CSS (HR, 0.73; 95% CI, 0.64-0.84). Results were consistent in propensity score analyses. CONCLUSIONS: NACT remains substantially underutilized in routine clinical practice. Our results suggest that perioperative chemotherapy is associated with a substantial survival benefit in the general population. Patients who are planning to undergo cystectomy for bladder cancer should be reviewed by a multidisciplinary team.	bladder
Using of immunocytochemistry in differential diagnosis of neoplasms of serosal cavities in dogs.	The presence of tumor within the serosal cavities, often connected with accumulation of serosal effusion, is a quite common problem in the small animal veterinary medicine. The first step in diagnosis of such cases is cytopathological examination. The aim of the present study was to evaluate the usefulness of cytology and immunocytochemistry, using commercially available antibodies (anti-cytokeratin, anti-vimentin, and anti-desmin), in differential diagnosis of malignant tumors located within serosal cavities in dogs. The final cytological diagnosis of carcinoma/adenocarcinoma, sarcoma, and mesothelioma was obtained on the basis of routine cytopathology and immunocytochemistry, and then confirmed by histopathology and immunohistochemistry. Cytoplasmic immunoreactivitiy of normal mesothelid cells and cytoplasmic immunoreactivity of hyperplastic mesothelial cells revealed constant and strong expression of all examined intermediate filaments: cytokeratin, vimentin and desmin. Application of routine cytopathology and immunocytochemistry allowed 32 neoplastic tumors to be detected: 19 cases of carcinomas/adenocarcinomas, 6 cases of sarcomas, 7 cases of mesotheliomas. Immunostaining of cytopathological samples with chosen set of antibodies: anti-cytokeratin, anti-vimentin, anti-desmin is a useful, and low invasive test for differentiation between mesotheliomas and carcinomas/adenocarcinomas in dogs.	bladder
External validation of existing nomograms predicting lymph node metastases in cystectomized patients.	OBJECTIVES: Karakiewicz et al. and Green et al. created pre-cystectomy nomograms to predict lymph node involvement. The aim of the study was to externally validate these two nomograms in intermediate-volume institutions in Europe. PATIENTS AND METHODS: Data from a Serbian single-centre cystectomy series comprising 183 patients with bladder cancer were used for the validation of two US nomograms, which were originally based on data from 726 and 201 patients, respectively. A multivariate regression model assessed the value of the clinical parameters integrated in the two nomograms. The expected predictive accuracy, calibration and clinical utility according to the nomograms were calculated. RESULTS: Comparison of our dataset with the previously published data shows differences in nearly all underlying risk variables. Overall, 109 (59.6 %) patients had lymph node metastases. The analysis demonstrated that hydronephrosis and status of lymph nodes on computed tomography have independent prognostic value. The performance of the nomograms deteriorated from the development set, and the predictive accuracies for the two models showed moderate discriminatory ability (61.2-69.1 %). In the decision curve analysis, only the Green et al. model predicting lymph node positivity provided net benefit. CONCLUSIONS: The Green et al. nomogram seems applicable to patients from Europe, despite varying risk factors in the validation dataset. Acceptance of such a tool into daily clinical management may lead to more appropriate decision-making. Nevertheless, further improvement and implementation of novel statistical models with enhanced predictive accuracy is needed.	bladder
Current status of robotic and laparoscopic techniques in radical cystectomy and diversion procedures for bladder cancer: review.	Across the world there has been an increased interest in minimally invasive approaches in extirpative and reconstructive surgery for bladder cancer. Minimally invasive approaches i.e. robotic and pure laparoscopic radical cystectomy have the greatest advantage of reduced blood loss, postoperative pain, quicker recovery of bowel function and earlier convalescence. Compared to established open techniques, there have been increasing reports of equivalent oncologic out comes and reduced complication rates in short and intermediate follow-ups. There have been several reports on urinary diversions achieved through minimal invasion and there is increasing interest to perform with robotic assistance. This review aims to review the currently published literature, technical aspects of the procedure, perioperative, oncologic and functional outcomes.	bladder
Educational opportunities in bladder cancer: increasing cystoscopic adherence and the availability of smoking-cessation programs.	Cancer survivors who continue to smoke following diagnosis are at increased risk for recurrence. Yet, smoking prevalence among survivors is similar to the general population. Adherence to cystoscopic surveillance is an important disease-management strategy for non-muscle-invasive bladder cancer (NMIBC) survivors, but data from Surveillance, Epidemiology, and End Results program (SEER) suggest current adherence levels are insufficient to identify recurrences at critically early stages. This study was conducted to identify actionable targets for educational intervention to increase adherence to cystoscopic monitoring for disease recurrence or progression. NMIBC survivors (n = 109) completed telephone-based surveys. Adherence was determined by measuring time from diagnosis to interview date; cystoscopies received were then compared to American Urological Association (AUA) guidelines. Data were analyzed using non-parametric tests for univariate and logistic regression for multivariable analyses. Participants averaged 65 years (SD = 9.3) and were primarily white (95 %), male (75 %), married (75 %), and non-smokers (84 %). Eighty-three percent reported either Ta- or T1-stage bladder tumors. Forty-five percent met AUA guidelines for adherence. Compared to non-smokers, current smokers reported increased fear of recurrence and psychological distress (p < 0.05). In regression analyses, non-adherence was associated with smoking (OR = 33.91, p < 0.01), providing a behavioral marker to describe a survivor group with unmet needs that may contribute to low cystoscopic adherence. Research assessing survivorship needs and designing and evaluating educational programs for NMIBC survivors should be a high priority. Identifying unmet needs among NMIBC survivors and developing programs to address these needs may increase compliance with cystoscopic monitoring, improve outcomes, and enhance quality of life.	bladder
Metformin sensitizes human bladder cancer cells to TRAIL-induced apoptosis through mTOR/S6K1-mediated downregulation of c-FLIP.	Metformin, an oral antidiabetic agent, has been reported to potentiate chemotherapeutic-induced cytotoxicity. In this study, we investigated the effects and molecular mechanisms of metformin in sensitizing tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-induced apoptosis in human bladder cancer cells. Metformin alone did not induce apoptosis, but markedly potentiated TRAIL-induced apoptosis in 253J and RT4 bladder cancer cells. To elucidate the underlying mechanism, we examined the modulatory effects of metformin on the key components of the TRAIL signaling pathway and found that metformin did not alter the expression levels of death receptor 4 (DR4) and death receptor 5 (DR5), but significantly reduced the cellular Fas-associated death domain (FADD)-like interleukin-1β-converting enzyme (FLICE) inhibitory protein (c-FLIP) levels, contributing toward the sensitization to TRAIL. Further experiments showed that metformin did not affect the mRNA level, proteasomal degradation, and protein stability of c-FLIPL. However, metformin inhibited the mTOR/S6K1 pathway in 253J and RT4 cells, which usually regulates protein translation; moreover, knockdown of S6K1 effectively reduced the levels of c-FLIPL, indicating that metformin downregulates c-FLIP through inhibition of the mTOR/S6K1 pathway. In addition, AMP-activated protein kinase (AMPK) inhibitor compound C did not prevent the inhibitory effects of metformin on the mTOR/S6K1 pathway and metformin-mediated sensitization to TRAIL. Taken together, our results indicate that metformin sensitizes human bladder cancer cells to TRAIL-induced apoptosis through downregulation of c-FLIP, which is mediated by the mTOR/S6K1 pathway, but independent of AMPK; furthermore, these findings provide a rationale for the combined application of metformin with TRAIL in the treatment of bladder cancer.	bladder
Urinary protein biomarker panel for the detection of recurrent bladder cancer.	BACKGROUND: Up to 70% of patients with non-muscle-invasive bladder cancer (NMIBC) experience disease recurrence, making it one of the most prevalent cancers in the United States. The purpose of this study was to test the performance of a multiplex urinary biomarker assay for the monitoring of voided urine for recurrent bladder cancer. METHODS: This retrospective, multicenter study included a total of 125 subjects with a history of bladder cancer. Voided urine specimens were collected before procedure from these subjects (53 with confirmed tumor recurrence and 72 with confirmed non-tumor recurrence) for analysis. A prediction rule generated from the performance characteristics of 10 single biomarkers (IL8, MMP9, MMP10, SERPINA1, VEGFA, ANG, CA9, APOE, SERPINE1, and SDC1) was measured using ELISA. The diagnostic performance of the biomarker panel was assessed using receiver operator curves (ROC) and descriptive statistical values (e.g., sensitivity and specificity). RESULTS: The combination of all 10 biomarkers outperformed any single biomarker with a calculated AUROC for the diagnostic panel of 0.904 [95% confidence interval (CI), 0.853-0.956]. The multiplex assay achieved an overall sensitivity of 79% and specificity of 88% for recurrent bladder cancer and significantly outperformed the Urovysion cytogenetic assay (sensitivity 42%, specificity 94%) and voided urinary cytology (sensitivity 33%, specificity 90%). CONCLUSIONS: A diagnostic panel of 10 urinary biomarkers that accurately detects primary bladder cancer also performs well for the detection of recurrent bladder cancer. IMPACT: The identification of a reliable urine-based surveillance and detection assay would be of benefit to both patients and the healthcare system.	bladder
Clog-free cell filtration using resettable cell traps.	The separation of cells by filtration through microstructured constrictions is limited by clogging and adsorption, which reduce selectivity and prevent the extraction of separated cells. To address this key challenge, we developed a mechanism for simply and reliably adjusting the cross-section of a microfluidic channel to selectively capture cells based on a combination of size and deformability. After a brief holding period, trapped cells can then be released back into flow, and if necessary, extracted for subsequent analysis. Periodically clearing filter constrictions of separated cells greatly improves selectivity and throughput, and minimizes adsorption of cells to the filter microstructure. This mechanism is capable of discriminating cell-sized polystyrene microspheres with <1 μm resolution. Rare cancer cells doped into leukocytes can be enriched ~1800× with ~90% yield despite a significant overlap in size between these cell types. An important characteristic of this process is that contaminant leukocytes are captured by non-specific adsorption and not mechanical constraint, enabling repeated filtration to improve performance. The throughput of this mechanism is 900,000 cells per hour for 32 multiplexed microchannels, or ~1,200,000 cells cm⁻² h⁻¹ on a per area basis, which exceeds existing micropore filtration mechanisms by a factor of 20.	bladder
A new tool for distinguishing muscle invasive and non-muscle invasive bladder cancer: the initial application of flexible ultrasound bronchoscope in bladder tumor staging.	OBJECTIVES: To validate the flexible ultrasound bronchoscope (FUB) as a tool in distinguishing muscle invasive and non-muscle invasive bladder tumors. MATERIALS AND METHODS: From June 2010 to April 2012, 62 patients (11 female and 51 male) with 92 bladder urothelial carcinoma were treated in our study. The mean (±SD) patient age was 64.0±12.5 years old (ranged from 22 to 87). Clinical T stage was assessed by FUB at first in operating room, then immediately initial diagnostic transurethral resection (TUR) was performed. A second TUR would be done 2-4 weeks after initial TUR when the latter was incomplete (in large and multiple tumours, no muscle in the specimen) or when an exophytic high-grade and/or T1 tumour was detected. And radical cystectomy would be performed for the patients who were diagnosed with muscle-invasive tumors. FUB staging and initial TUR staging, final pathological results were compared. RESULTS: In ultrasonic images, the normal muscle layer of bladder wall could be clearly distinguished into three layers, which were hyperechogenic mucosa, hypoechogenic muscle and hyperechogenic serosal. For non-muscle invasive tumors, the muscle layers were continuous. And distorted or discontinuous muscle layers could be seen in muscle-invasive case. The overall accuracy (95.7%) and the specificity of muscle invasion detection of FUB (98.8%) were comparable to TUR (overall accuracy 90.2% and specificity 100%), but sensitivity of muscle invasion detection of FUB was significantly higher than initial TUR (72.7%VS18.2%). Moreover, the tumor's diameter could not affect the FUB's accuracy of muscle invasion detection. For tumors near the bladder neck, FUB also showed the similar validity as those far from bladder neck. CONCLUSIONS: To conclude, the flexible ultrasound bronchoscope is an effective tool for muscle invasion detection of bladder tumor with ideal ultrasonic images. It is an alternative option for bladder tumor staging besides TUR. It might have the potentiality to change the bladder diagnostic strategy.	bladder